Project Summary/Abstract Recent research shows that many individuals with neuromuscular, neurological, and developmental disorders, including those suffering physical injury or tremors, are at a higher risk of poor oral health, including more dental caries, periodontal disease, and soft tissue pathology compared to those without disability. This population of roughly 52 million disabled Americans encounter barriers to routine, comfortable, and effective oral hygiene self-care, resulting from problems with grasp, muscle control, range of motion, and reduced manual dexterity. Many of these individuals require assistance from caregivers to perform daily oral hygiene, reducing independence. Caregivers often report great difficulty in safely and comfortably performing these services due to lack of training, time, or confidence in managing the complexities of oral hygiene care. Surveys of current devices to assist in the daily oral care for disabled persons show only limited manual solutions, including potentially uncomfortable props to keep the mouth open and modified grips for standard toothbrushes. Current electric toothbrushes still require a degree of manual control. Inadequate daily hygiene promotes oral disease in disabled individuals, who are subjected to dental care access barriers by limited financial resources, inadequate Medicaid dental coverage and providers, and a limited pool of professionals proficient in the care of the disabled. Thus, a significant unmet need exists to support daily routines for those with oral hygiene disabilities and their caregivers with a safe, automatic, affordable, easily operated, effective solution to facilitate regular oral care and reduce caregiver burden. As an effective and novel approach to reduce difficulties and apprehension while increasing adherence and safety, ASTER Labs, Inc. proposes to construct a hands-free automatic system in the form of a comfortable mouthpiece to simplify routine oral hygiene care. The device will operate using powered, automatically moving bristles and is simply inserted into the mouth to automatically remove plaque and debris. The mouthpiece includes embedded sensors to adjust the firmness and speed of the bristle motion, and to wirelessly transmit usage information to caregivers monitoring adherence and status. The goal of this new easily operated device is to increase plaque removal, oral care frequency, and adherence, to help reduce the risk of oral disease in individuals whose disabilities may interfere with use of standard oral hygiene devices. This will also reduce burden and emotional stress on caregivers. An LCD display on the recharging base station and wireless status reports will further promote adherence by helping prevent disruptions in daily hygiene leading to deterioration in oral health. The system design includes multiple safety features to ensure patient comfort and well-being during daily care. By providing a technically advanced and practical dental care system for those with oral hygiene disabilities and their caregivers to use in the comfort of a home or care facility, regular and effective oral hygiene can be improved, reducing the burden of preventable oral disease and treatment need in this vulnerable population.